the Combination of Palonosetron and Aprepitant Shows Superior Protection From Significant Nausea and Vomiting Than Daily Granisetron in Patients Receiving High Dose Chemotherapy As Conditioning Prior to Stem Cell Transplantation

New data presented at the European Hematology Association (EHA)
2011 Annual Meeting in London show better control of nausea and
vomiting with the combination palonosetron plus aprepitant when
compared to granisetron in patients receiving multiday highly
emetogenic conditioning chemotherapy regimens - Significantly
higher the complete response during the acute, delayed and overall
periods

London, 10th June 2011 - The combination of palonosetron (0.25
mg iv every 48 h) and aprepitant (125 mg on day 1, followed by 80
mg each of the remaining days) improves control of CINV
(Chemotherapy Induced Nausea and Vomiting) compared with daily
granisetron (3 mg iv) during the conditioning period (5-6 days) of
patients prior to stem cell transplantation (HSCT).

“Nausea and vomiting in patients receiving high-dose,
multiday conditioning regimens prior to stem cell transplantation
is particularly common and affects between 55 and 100% of the
patients”, Javier López-Jiménez, Hospital
Ramón y Cajal, Hematology Department and the lead
investigator, said. “CINV is particularly troublesome,
especially in the delayed phase beginning 24 hours after the start
of conditioning. Though newer anti-emetics as palonosetron and
aprepitant appear to significantly reduce acute and delayed CINV,
in comparison to the older 5-HT3 receptor antagonists, few studies
had prospectively evaluated the efficacy of these drugs in this
very challenging setting”, he explained.

Sixty consenting patients were included in the study, received a
conditioning regimen prior to HSCT, and an anti-emetic prophylaxis
(31, palonosetron + aprepitant; 29, granisetron). Significantly
more patients in the group treated with the combination of
palonosetron and aprepitant had a complete response - defined as no
emesis and no use of rescue medication - during the acute (0-24h;
92.3% versus 67.9% in the granisetron group), delayed (24-120h;
61.5% versus 28.6%, respectively) and overall (0-120h; 61.5% versus
28.6%, respectively) periods.

In addition, palonosetron plus aprepitant significantly reduced
the proportion of patients with emesis during the acute, delayed
and overall periods and showed a trend toward a reduction in
percentage of patients with significant nausea during the delayed
period.

There were no significant differences between the groups in
adverse events or in the times of engraftment or severe
infections.